The overall objective of this project is to develop, implement, and evaluate the effectiveness of culture-specific, community-based diabetic eye disease screening clinics in increasing the percentage of African Americans with diabetes who obtain annual eye examinations and appropriate follow-up care. This type of community-based eye screening clinic is intended to augment the existing health care delivery system with a new, low cost and self-sustaining model for enhancing the eye care of adults with diabetes. The project will use focus groups and collaborating community-based sponsoring organizations to develop and implement-culture- specifics community-based eye screening clinics for urban African Americans with diabetes. The clinics are expected to screen at least 700 patients in 36 clinics over the life of the project. The major hypothesis of the study is that following the screening clinics a significantly greater percentage of persons randomized to an aggressive follow-up system regarding their future eye care (i.e., letter, telephone call, etc.) will seek a yearly follow-up diabetic eye exam than a control group who receives standard follow-up recommendations. It is expected that a minimum of 80% of the clinics will continue and be self-sustaining at the end of the project. The project will also develop and disseminate nationally, a manual that contains all the procedures, forms, and information necessary to enable other organizations to establish similar clinics. It is anticipated, also, that the Michigan Diabetes Research and Training Center (MDRTC) will provide seminars for health professionals as well as telephone and mail consultation on how to develop similar successful models for culture-specific, community-based screening clinics beyond the funding period for the project.